Douglas Haggstrom

Consultant

Finding new models to keep us healthy

Finding new models to keep us healthy

12.12.2017

The last DayOne Experts event of 2017 had over 90 participants who came to hear about disruption in healthcare insurance and both how it affects the Pharma industry and how together Pharma, Insurers and others can work to find a better model for all parties.

A number of speakers presented different perspectives on Healthcare insurance and then there was a panel discussion. This panel discussion focused on some specific disruptions and what are the principles that society needs to keep in mind and debate as new business models are developed. Presentations are available for your reference in PDFs at the end of this event report.

Anke –Peggy Holtorf from Health Outcomes Strategies began with reminding us of the goals of a healthcare system and how insurance is a balance of getting the best “outcomes” for the lowest cost.  She then described how the changing role of the patient and also precision medicine is changing what this optimal “outcome” is. This wil be closer to the patients’ interests and not that of the clinician.

Siddarth Srivastava from the TPH then gave us a different perspective from his work in Tanzania. He reminded us that Insurance needs to be seen in a wider context. Universal access is a mix of not only financing but also other building blocks like a trained workforce, access to medicines and a functional Health Information System.  Siddarth presented on both the challenges of financing in Tanzania but also an exciting project on the development of an open source Insurance Management Information System (IMIS). This system is now covering over 756,000 individuals or in other words more than any individual health insurer in Switzerland! This open source program is a mobile-first installation with a number of innovations like integrated mobile payments, common SMS gateway for adherence reminders, appointments etc that would be welcomed by many in more developed markets.  

Koen Torfs from Actelion/Janssen discussed the challenge of proving the “value” of a new drug when the definition of value is still unclear. This is particularly pressing as the current options for “value” may not be able to enable payment for true innovations like treating to prevent diseases like Alzheimer’s rather than waiting for patients to fall ill. Koen also showed some historical data on drug prices and overall healthcare costs. He, perhaps controversially, pointed out that life won’t be so bad if we spend more of our GDP on healthcare? After all, what better use is there for money than our own health? Koen’s recommended reading the Cost Disease is in the footnotes.

Tim Wintermantel from IQVIA took up the theme of data and evidence and gave some insights into how we can with more and better data make improvements within the existing system. This could be both better choosing which drugs get funded but also informing how drugs are used.

 

The panel discussion focused on a number of disruptions to the existing insurance model. Peter Ohnemus from Dacadoo spoke about their efforts to encourage individuals to improve their health with a personal health score and also highlighted how potentially patients could use their own data to pay for treatments. The topic of behavioural economics in healthcare will be followed up in a DayOne expert event in April 2018

Other topics covered included a number of innovations such as; the rise of digital-first insurers, open source insurance models, pharma collaboration and other ways to bring down the price of development and combined pricing and payment solutions from Insurers and Pharma. There were however, some notes of caution such as making sure we don’t give up the solidarity principle by accident and that we apply unbridled capitalism and disruption only where it makes sense in the system.

We hope to continue discussions on the fundamental theme of who will pay for healthcare in the future during 2018. Next time with an Insurer on stage!

Koen’s recommended reading – The Cost Disease https://yalebooks.yale.edu/book/9780300198157/cost-disease

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